Alzheimer's Disease: Improv Keeps Patients in the Present

Here is a way for nurses administrators, social workers and other health care professionals to get an easyceu or two

ABC News/health

By KATIE MOISSE

Once a theater enthusiast, Wolfgang Roth now struggles to follow his favorite plays. Since he was diagnosed with Alzheimer's disease four years ago, Roth's memory has continued to fade. But at improv classes, the retired professor still lights up in the room.

Monday mornings, 80-year-old Roth meets up with the Memory Ensemble -- an improv group for people with early stage Alzheimer's and other forms of dementia. For 90 minutes, the ad-libbing actors transform a tiny room at Chicago's Northwestern University into a spontaneous stage where fleeting memories matter not.
"He has a ball," said Roth's wife, Mary Beth. "It's fun and it keeps his brain active."
For the Roths, the lighthearted improv sessions help lift the heavy burden of Alzheimer's -- an unstoppable disease that plagues 5.4 million people in the United States.
"Until we have a cure and a treatment to prevent Alzheimer's, one of our missions is to help people cope and live with this disease," said Mary O'Hara, a social worker at the Cognitive Neurology and Alzheimer's Disease Center at Northwestern University Feinberg School of Medicine. Improv, she said, is one way to do just that.
"There aren't a lot of programs that are specifically designed for individuals with early stage disease. These people are told by doctors to stay active, keep their brains active and stay socially engaged. But memory loss makes it harder to do those things."

The Memory Ensemble, run jointly by the Cognitive Neurology and Alzheimer's Disease Center and the Tony Award-winning Lookingglass Theater Company, lets patients exercise creativity and wit despite failing memories. It's all about the present, said O'Hara.
"Improv is just all about being in the moment and being spontaneous, and there's no right or wrong answer," she said. "For someone with memory loss, it's a really good fit because they still have imaginations and come up with wonderful ideas."

Alzheimer's Disease: Improv Keeps Patients in the Present

Even if confusion creeps in, the group just goes with it. When playing a student, Roth was told he had to stay in and study for a test.
"He said, 'Intestine? What are you talking about?'" Mary Beth recalled. "Everyone thought he was so funny, and he is."
In its early stages, Alzheimer's disease leaves its victims very much aware of the inevitable memory loss that will penetrate their relationships, their identities.
"It's very devastating when someone finds out they have this," said O'Hara. "When people hear 'Alzheimer's disease,' they picture people in the later stages; not someone who's physically healthy and wanting to do things. This is a chance for patients to share in something new together and know they're not alone."
Roth rarely remembers the events of the class. But his wife debriefs him over lunch.
"It's a joy to do this with him," Mary Beth said. "It's a chance to see my husband in public, showing his vulnerability less. It just feels more like the old Wolfgang."
The Memory Ensemble also allows caregivers to connect with each other.
"It's like a support group for me," Mary Beth said. "It alleviates some of the stress, the isolation. I feel like they're helping me maintain my mental health."
O'Hara is using surverys to measure the impact of improv on patients' quality of life. She hopes her research will generate credibility and funds for similar programs nationwide.
For the Roths, the 90-minute class makes missing memories and an uncertain future irrelevant -- however temporarily.
"It's affirming. It helps him feel good about himself," said Mary Beth. "He comes out very positive and upbeat, chattering to the others and to me. He's just happy."